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The primary duty involves accurately posting payments and necessary adjustments to patient accounts while strictly maintaining compliance and confidentiality. Essential functions include reviewing Explanation of Benefits, manually posting payments, generating adjustments, and balancing daily posting batches.
Requirements summary
A high school diploma or GED is required, with a preference for one or more years of related experience in medical billing within a practice facility setting. Candidates should possess strong computer skills, the ability to manage competing priorities, and knowledge of relevant coding and third-party regulations is preferred.
Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years! We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, PTO, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance, Development and more. For additional information visit https://www.austinregionalclinic.com/careers/ [https://www.austinregionalclinic.com/careers/]
PURPOSE
Performs all duties required to accurately post payments and appropriate adjustments to patient accounts. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.
Essential functions
Reviews carrier explanation of benefits to determine accurate reflection of carrier, provider and patient responsibility.
Opens payment posting batches recording correct payment method, check number, deposit date and type of payment posted.
Researches and determines appropriate invoice, patient account, date of service, and payor in which to post payment.
Manually posts patient and insurance payments through assigned batches according to designated deposit dates.
Generates any adjustments necessary to complete correct posting of payments and adjustments using appropriate A/R and ANSI
Ensures accurate transfer of outstanding balances to next responsible party as indicated by payor explanation of benefits.
Closes, processes, balances and compiles payment posting batches daily.
Balances daily posting receipts and accurately enters all batches into Daily Receipt Activity Summary.
Contacts insurance carriers as needed for: missing payments, missing explanation of benefits, posting clarifications in order to post items accurately, or additional information needed to apply payments
Benefits
Life Insurance
Medical
Dental
Vision
401(k)
PTO
Tuition Reimbursement
Flexible Spending Accounts
Long Term Disability
Development
EAP
Child Care Assistance
Health & Fitness
Sick Child Care Assistance
Performs ERA downloads from various payors and bank deposits as assigned for all lines of business.
Audits e-remit files for correct balancing, payments, adjustments, ANSI code denials and next responsible party actions before acceptance.
Utilize desktop scanner to remotely deposit live checks received daily
Prepares Local, Lockbox, and EFT deposits daily
Prepare EFT for daily posting assuring accuracy with amount deposited daily
Download remittance ERA from clearinghouse and complete FTP process daily
Open, sort, and appropriately distribute Lockbox correspondence daily
Accurately posts insurance payments and adjustments from e-remit error reports.
Prints and records all e-remit reports.
Makes necessary copies of credits and appeals to forward for appropriate follow-up activity by other CBO departments.
Obtains supervisor signature on all large dollar write-offs according to established policy.
Follows established guidelines to ensure timely entry of all receipts to meet monthly deadlines.
Posts insufficient fund fees and adjustments.
Posts Agency receipts and reports to collector for appropriate follow-up adjustment.
Utilizes all payor website systems & tools to obtain accurate patient eligibility and Claim detail.
Processes Credit Card payments and posts payments to accounts.
Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
Regular and dependable attendance.
Follows the core competencies set forth by the Company, which are available for review on CMSweb.
Other duties and responsibilities
Keeps complete, accessible, dated files.
Provides assistance to coworkers as requested and/or necessary.
Provides workload statistic reports to management team.
Responds professionally and effectively to questions from external sources, i.e., customer or carrier, and internal sources, i.e., provider or management team.
Attends required in-services/training sessions.
Performs other duties as assigned.
Qualifications: Education and Experience
Required
High school diploma or GED.
Preferred
One (1) or more years of related experience working with medical billing in a practice facility setting.
Knowledge, Skills and Abilities
Prefer knowledge of using computer data processing systems.
Prefer knowledge of and experience in ANSI denial codes.
Prefer knowledge of and experience in effective use of CPT, ICD-9 and HCPCS coding.
Prefer knowledge of legislative and private sector third party regulations and guidelines.
Ability to engage others, listen and adapt response to meet others’ needs.
Ability to align own actions with those of other team members committed to common goals.
Excellent computer and keyboarding skills, including familiarity with Windows.
Excellent verbal and written communication skills.
Ability to manage competing priorities.
Ability to accurately use Ten key
Ability to perform job duties in a professional manner at all times.
Ability to understand, recall, and communicate, factual information.
Ability to understand, recall, and apply oral and/or written instructions or other information.
Ability to organize thoughts and ideas into understandable terminology.
